COVID-19 remains top concern for ICU staff, despite B.C.'s progress tackling pandemic

·6 min read
Stephanie Stanton, a nurse at Royal Columbian Hospital in New Westminster, B.C., dons personal protective equipment while working in the intensive care unit. (Christian Amundson/CBC - image credit)
Stephanie Stanton, a nurse at Royal Columbian Hospital in New Westminster, B.C., dons personal protective equipment while working in the intensive care unit. (Christian Amundson/CBC - image credit)

For 18 months, intensive care unit physician Dr. Steven Reynolds has been consumed by thoughts of COVID-19.

He thinks about the levels of personal protective equipment, the congestion in the ICU and how frontline workers are faring.

"I'm concerned for some of their mental health and I'm concerned for their burnout,'' said Reynolds, site medical director at Royal Columbian Hospital in New Westminster, B.C.

He's not the only one.

Amid a steady drop in new cases and a surge in vaccination, there's a sense among British Columbians that the province has turned a corner in the pandemic. That sense was boosted by the government's announcement of a four-step restart plan, which aims to lift virtually all COVID-19 restrictions as early as September.

In ICUs across the province, however, COVID-19 remains a concern for frontline workers like Reynolds, as well as patients and their families.

ICU physician and Royal Columbian site medical director Dr. Steven Reynolds, seen here wearing personal protective equipment, describes the past year as 'exhausting' and 'crushing.'
ICU physician and Royal Columbian site medical director Dr. Steven Reynolds, seen here wearing personal protective equipment, describes the past year as 'exhausting' and 'crushing.'(Christian Amundson/CBC)

"We're still here, we're still working, we're still trying," said Reynolds, "You can't let your guard down."

When asked about the pandemic, frontline workers interviewed by CBC News, including four registered nurses and a respiratory therapist, describe an active situation, saying they are still seeing younger and sicker patients compared to the first wave of the pandemic.

"As people are getting vaccinated ... I think that has a huge impact on what we see," said registered nurse Gary Wong, "Some don't go home and we've had to stick by their bedside and support them."

Health complications from COVID-19

Among those receiving care at Royal Columbian is 44-year-old Jeremy Johnson, whose COVID-related complications have left him in ICU for more than six weeks.

In April, the father of two tested positive for COVID-19 and was isolating at home when his condition deteriorated.

Wife Rika Johnson, a nurse who had been working at the COVID-19 Testing and Immunization Centre in Coquitlam, says he suffered a fever and chills and eventually started vomiting and struggling to breathe.

She took him to Burnaby General Hospital, where he was diagnosed with pneumonia secondary to COVID-19, as well as bacterial pneumonia. Days later, his oxygen levels dropped and he was brought to Royal Columbian.

While he no longer has COVID-19, Johnson still faces significant health hurdles, including kidney failure.

"His lung capacity is not fully normal … he's got a tracheostomy now," said registered nurse Dave Riar. "He's still quite sick, he's still in septic shock just from a bacterium now."

Jeremy Johnson, who tested positive for COVID-19 in April, is seen at left with his wife Rika and the couple's two children.
Jeremy Johnson, who tested positive for COVID-19 in April, is seen at left with his wife Rika and the couple's two children.(Courtesy: Rika Johnson)
Jeremy Johnson has spent more than six weeks in Royal Columbian Hospital's ICU after testing positive for COVID-19 in April.
Jeremy Johnson has spent more than six weeks in Royal Columbian Hospital's ICU after testing positive for COVID-19 in April.(Christian Amundson/CBC)

Rika Johnson, meanwhile, says she is still living "a COVID life." Until only recently, she and her two boys were not allowed to visit Jeremy, who she says is in critical condition and heavily sedated.

"It was nice to hold his hand … to let him feel our touch and let him hear my voice next to him instead of being on FaceTime," she said.

The experience has left her questioning whether the province's timeline for reopening is safe, and she cited concerns about more contagious variants of the coronavirus.

"I want my life back to normal with my husband," she said. "But I don't want anyone else to go through this because this is just heart wrenching."

Last breaths

Outside of immediate family, frontline workers are among the select few to see the devastating impact of the pandemic on B.C.'s ICUs in real time.

For registered nurse Jennifer Reaveley, the intensity of the past few months is reflected in her day planner.

In May she worked 20 shifts in 31 days, each of them 12 hours long — nearly double the usual average. Adding to the stress was the sheer number of patients being admitted to the ICU.

Registered nurse Jennifer Reaveley sanitizes her hands after leaving a patient's room in the intensive care unit of New Westminster's Royal Columbian Hospital.
Registered nurse Jennifer Reaveley sanitizes her hands after leaving a patient's room in the intensive care unit of New Westminster's Royal Columbian Hospital.(Christian Amundson/CBC)

Reaveley says that because of COVID safety protocols, she and other nurses were often the only people in the room for a patient's final breaths. One man, who was in his 50's, died while she facilitated a video call with his wife.

"She was crying her eyes out and reminding him of their wedding day and their little kids and how she will protect them and [saying] she will remind the kids of the stories of him and that they will be proud of who he was as a person," Reaveley recalled.

"We took him off life support and his heart rate slowly started to drop down and his blood pressure started to fade away. And it was me that was holding his hand. [His] family were just sitting on a square screen. That's cruel to not to be a part of that in person, but we were the closest people that could provide that care and that touch at that moment."

'Coming up the other end'

Patient care coordinator Kathleen Olekshy says nurses have been "closest to the suffering" during the pandemic. At the same time, she says it's nice to think "we're coming up the other end of it."

"We are going to have COVID-19 survivors and then we're going to have family members of people that they lost in COVID-19," she said.

"There is a lot of recovery to be done, and certainly there are going to be a lot of people that will have some long-lasting effects from this."

A flyer reminds visitors and staff at Royal Columbian Hospital, in New Westminster, B.C., to take precautions to prevent the spread of COVID-19.
A flyer reminds visitors and staff at Royal Columbian Hospital, in New Westminster, B.C., to take precautions to prevent the spread of COVID-19.(Christian Amundson/CBC)

Like other staff, she believes the pandemic has taken a toll on frontline workers, saying personal protective equipment has even affected the way she interacts with her coworkers.

"There was this vaguely dehumanizing effect that happened. I could no longer read my colleagues' faces. I could no longer sense their emotion when they were feeling overwhelmed or nervous or needed back up," she said.

Olekshy said they have "gotten very good at reading each other's eyes."

For physician and site director Reynolds, however, the question is not if the ICU can resume normal operations, but when.

"Folks are tired," he said. "The challenge is to be able to to refocus after this and to get our strength back to be able to do regular work that was challenging to begin with."